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    Öğe
    Once-monthly continuous erythropoietin receptor activator (CERA) for haemoglobin maintenance in haemodialysis patients with chronic renal anaemia
    (Oxford Univ Press, 2014) Duman, Neval; Uyanik, Abdullah; Unsal, Abdulkadir; Sezer, Siren; Camsari, Taner; Cirit, Mustafa; Yilmaz, Mehmet Emin
    Background. This study was conducted to evaluate the efficacy and safety of once-monthly continuous erythropoietin receptor activator (CERA) for maintenance of stable haemoglobin (Hb) levels in adult chronic renal anaemia patients on dialysis according to local clinical judgment in Turkey. Methods. This was a prospective, open-label, single-arm, multi-centre study conducted in 20 centres in Turkey. After a 4-week screening period, eligible patients receiving conventional erythropoiesis-stimulating agents were converted to monthly intravenous CERA and entered a 16-week CERA dose-titration period (DTP) followed by an 8-week efficacy evaluation period (EEP) and a 4-week safety follow-up. The primary endpoint was the proportion of patients whose Hb concentration remained stable within +/- 1.0 g/dL of their reference Hb and within the range of 10.0-12.0 g/dL during the EEP. Results. A total of 173 patients were screened, 132 entered the DTP and 84 completed the study. Thirty-nine patients [46.4%(95% confidence interval: 35.5-57.7%)] maintained stable target Hb concentrations. The mean change in time-adjusted average Hb concentration was 0.29 +/- 1.08 g/dL between baseline and the EEP. The mean CERA monthly dose was 112.4 +/- 76.78 mu g during the EEP, and the CERA dose was adjusted in 39 patients (36.4%). Eleven patients (8.4%) reported 13 treatment-related adverse events, the most frequent adverse events being infections and infestations, gastrointestinal and vascular disorders. Conclusions. Once-monthly CERA maintains stable Hb concentrations in chronic renal anaemia patients on dialysis in Turkey. The study results confirm the known efficacy and safety profile of CERA.
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    Öğe
    What is the optimal dwell time for maximizing ultrafiltration with icodextrin exchange in automated peritoneal dialysis patients?
    (Multimed Inc, 2006) Jeloka, Tarun K.; Ersoy, Fevzi F.; Yavuz, Mahmut; Sahu, Krishna M.; Camsari, Taner; Utas, Cengiz; Bozfakioglu, Semra
    Background: Icodextrin is increasingly being used in automated peritoneal dialysis (APD) for the tong dwell exchange to maintain adequate ultrafiltration (UF). However, the UF reported in the literature varies with different dwelt times: from 200 to 500 mL with 12 - 15 hour dwells. In order to maximize UF, it is important to know the relationship between dwell time and UF when using icodextrin in APD patients. With this knowledge, decisions can be made with respect to dwelt period, and adjustments to the dialysis prescription can be made accordingly. Methods: We prospectively studied this relationship in 36 patients from Canada and Turkey. All patients did the icodextrin day exchange manually after disconnecting themselves from overnight cycler dialysis. Dwell period was increased by 1 hour every week, from 10 to 14 hours. Ultrafiltration was noted for each icodextrin exchange. Mean UF for each week (i.e., dwell period) was compared by repeated measures ANOVA. Results: We found no difference in mean UF with increasing dwelt time: 351.73 +/- 250.59 mL at 10 hours versus 371.75 +/- 258.25 mL at 14 hours (p = 0.83). We also compared mean UF between different subgroups and found that mates (p = 0.02 vs females) and high transporters (p = 0.04 vs low) had higher mean UF. Further analysis of maximal UF showed no correlation to age, sex, diabetic status, transport category, creatinine clearance, Kt/V, duration on peritoneal dialysis, or duration of icodextrin use. Conclusion: Icodextrin-related UF in APD patients is not related to demographic factors and does not increase significantly beyond 10 hours.